Can You Really Trust Your Therapist?

by Neseret on May 11, 2013

523546_516069328450246_1404824943_n[1]I recently came across this beautiful picture about what it means to be “a holistic” conscious spiritual entrepreneur/practitioner.

What struck me most about this picture is the message of living in integrity and not compartmentalizing our lives as therapists/coaches/healers.

This idea of integrating all parts of our life as individuals and thrapist/coaches/healers is an ongoing journey. Furthermore, it is

an essential step in our evolution of becoming more of who we truly are as unqiue and authentic beings.

Personally, I had been taught one way about the boundaries between the clinician-client relationship. Looking back I realize the traditional helping profession teachings about those boundaries are very rigid and quiet impersonal.

Those rules and teachings often felt very restricting and unnatural. I believe it made my relationship with clients somewhat awkward. It was difficult to build intimacy and trust.

The message above brings such a crucial clarity around an issue I believe many clinicians struggle with – self disclosure.

What exactly is self disclosure?

Self-disclosure is both the conscious and subconscious act of revealing more about oneself to others. This may include, but is not limited to, thoughts, feelings, aspirations, goals, failures, successes, fears, dreams as well as one’s likes, dislikes, and favorites. …Self-disclosure is an important building block for intimacy, intimacy can not be achieved without it ~ Wikipedia ~

You go to see a therapist and from day one you are bombarded with a million and one questions about the most intimate details of your life. There is an unspoken rule/expectation that you will answer all of those questions.

You notice whenever you ask your therapist a personal question more than likely they will give you a very brief impersonal answer, and or politely decline to answer the question and quickly turn the focus back to you.

It is as if you just handed them a hot potato…

They have to get rid of it as quickly as possible. This is because most clinicians are taught (I would almost dare to say brain washed)  to do as little self disclosure as possible. Otherwise you’d run the risk of being “unprofessional” and your work with the client not being “therapeutic”/helpful.

I remember being in nursing school and hearing my clinical instructors and professors harping on this like there was no tomorrow. I mean every time I ever revealed the minutest amount of detail about myself I felt guilty and ashamed.

Most clinicians would be mortified about how much information I share about myself with the world on my blog. I’ve had some who’ve come out and told me there was no need for such foolishness.

I assure you I continue to work on my narcissistic tendencies.

Today, despite research showing clinical outcomes/(results in therapy) are closely connected with the therapeutic relationship (the bond or alliance client feels with their clinician), the education system and many clinitians continue to advocate and practise minimal self disclosure.

the therapeutic relationship contributes a hefty 30% to outcome in psychotherapy, making it a far more critical factor than either therapeutic technique or expectancy. Clients who are motivated, engaged and connected with the therapist in a common endeavor will benefit the most from therapy. Their participation is, of course, largely a result of the bond or alliance that clients form with the helping professional; studies show that the consumer’s participation in therapy is the single most important determinant of outcome. What is more, several studies have found that clients’ ratings of that bond or alliance, rather than the therapists’ perceptions, are more highly correlated with outcome. ~ No More Bells or Whistles by Scott Miller, Mark Hubble & Barry Duncan,1995, authors of the Heart and Soul of Change ~

Now, when you discover something is more helpful to your client and continue to practise against that advise – how does that affect the relationship you have with your client?

There is incredible power imbalance in the therapist-client relationship. Most clinicians hide behind a professional cloak and keep themselves safe. This only alienates the client and makes them feel like they can not trust their therapist.

They have this person who they know absolutely nothing about demanding from them to disclose pretty much everything. Yet the therapist is unwilling to reciprocate even slightly.  Most people would not accept that type of treatment in any  relationship, but

why is it acceptable when it comes from a therapist?

I believe part of it comes from this assumption that therapist are experts and so there is an automatic trust in the idea that they know what they’re doing. Sort of like  “the white coat syndrome“.

Well, when you’ve been going to a therapist for 2, or 3 or 10 years and nothing has changed – I would say that is a huge red flag. Or you feel like you can not tell your therapist certain things, because you “feel uncomfortable” or you’re “afraid” to tell them, or you think they’ll “judge” you if you tell them something  – that is also an indication there is a serious problem in the relationship.

The trust and intimacy are not there.

I believe clients need to know their therapist is a human being. People need to know that the person who they’re talking to can relate to them on some level. This is part of what builds that “intimacy” and trust. It doesn’t take a genius to figure this one out.  Yet this is a common sense that is not so common in many helping professions.

There is obviously a balance between disclosing information that is helpful to clients and disclosing information that is not. That balance is sometimes a tough one to figure out. I know I’ve struggled with it coming from one extreme and going to the other. I’m in the process of finding the “sweet spot”.

Ultimately I want to see my clients thrive.

I want them to know I’m just like them, a human being doing my very best. I want my clients to know they’re not alone in their struggles. I want them to feel unconditional acceptance and positive regard from me. I also want them to feel like they’re progressing in our work/journey together.

I realize how we view our relationship with clients will impact on how we treat them. It impacts on how we go about building and creating that relationship. If we see ourselves as “the experts” and the client is “a case” then the relationship we build with them is different than if we look at the client as the expert in their own lives and we are there to facilitate and support growth.

In the clinical literature, clients have long been stereotyped as the message bearers of family dysfunction, the manufacturers of resistance and, in the strategic tradition, the targets for the presumably all important technical intervention. Rarely, however, have clients been identified as the chief agents of change. Nevertheless, the client is actually the single most potent factor, contributing an impressive 40 percent to outcome. The quality of a client’s participation in treatment, his or her perceptions of the therapist and what the therapist is doing, determine whether any treatment will work. In fact, the total matrix of who they are, their strengths and resources, the duration of their complaints, their social supports, the environments in which they live, even fortuitous events that weave in and out of their lives matters more heavily than anything therapists might do. ~ No More Bells or Whistles by Scott Miller, Mark Hubble & Barry Duncan, authors of the Heart and Soul of Change ~

Self disclosure done in a balanced way will be a great benefit to clients.

It will build trust and intimacy in the therapeutic relationship. It will help clients gain more confidence to open up and share their experiences. Self disclosure is part of what will create that “safe space” where clients feel comfortable to be themselves.

I would love to hear some of your thoughts, views, and experiences about this topic. Client and clinician alike welcome. Please take time to share below.

If you found this article helpful share it on Facebook and Twitter. Thank you.

Peace, Love & Gratitude,

Neseret

{ 6 comments… read them below or add one }

marquis June 14, 2013 at 12:04 am

I see a therapist and been seeing her for almost a year. I have butted heads with her on different things because I don’t agree with she has to say about my parents and I told her I will not agree to something that isn’t true. I see this therapist through the State as they are paying for it.

Other issues I am still having is I feel I am not moving forward enough to be better, just the same old stuff she is having me to do. She told me to be in the now instead of the future or whatever as we were discussing the jobs issue 2 weeks ago. She wants me to have a change in perception and stop being a “victim.” She said how I am so bound by being a victim that I can’t see the other side of things.

I wanted to go to therapy on an holistic level, but do not have the money to do that, so have to settle with the state.

Reply

Neseret June 14, 2013 at 4:19 pm

Government/State mandated programs are very limited in the support and results they can provide people. The reason is because they are often following the medical model. The medical model focuses on symptoms of disease and treats same without going to the root cause so that people can experience last solutions.

Government/State mandate doesn’t always allow therapist to tackle important areas such as trauma and spirituality. Therapist who work for the government work within a very restricted framework. They have an insane amount of “caseload”/number of people they have to work with. They’re overworked and at that told how to do their job. It is not that they don’t want to help people, it is that they are not given the right environment and opportunity to do so.

Holistic approach requires time and effort both on the therapist and client’s part, but it provides lasting solutions. For the government, the goal is about cost-effectiveness and efficiency, not necessarily about quality of client care. Ultimately the quick-fix, sloppy job approach is inefficient, more costly, and unethical. It is not o.k to see people continuing to suffer needlessly.

Know that there is always hope and a way for you to move forward in your life. If you have the desire to heal, the way will be made for you.

Peace, Love & Gratitude,

Neseret

Reply

marquis June 18, 2013 at 5:55 pm

I agree. So, they are just like any other doctor only do what they were told to do in school – nothing less and nothing more. I feel like I am partially healing, but not enough to move forward. I told my therapist I feel you can’t move forward in an abusive environment, it’s like she is expecting miracles or something.

I feel I would be better off away from my parents, but have no income to do that nor do I have any family or friends to stay with for a while….

Reply

Neseret June 18, 2013 at 7:26 pm

Marquis,

What is holding you back is not being in an “abusive environment or having no income or family or friends to stay with”. What is holding you back is your limited thinking and attitude about yourself, your situation, and life.

Your thinking is of course influenced by the environment you grew up in and around as well as the experiences you’ve had in your life. However, you can learn to think differently and overcome your challenges.

In this percise moment you have everything you need within you to create a meaningful, successful, and happy life. I believe a holistic approach is necessary in order to draw out that potential from within you and to bring you back to life.

This process I call “The Journey of Hope” is nothing short of a miracle. It has happened in my own life and it is absolutely possible in yours. When you are ready…

Reply

marquis June 19, 2013 at 8:23 am

My therapist did say my limited beliefs and I told her in one sessions ‘jobs are so hard to find even though I have a degree but can’t get into my field anyway without the experience and all the knowledge in the world, isn’t gonna get me in the field – that I do know. It’s true, old friends deserted me and I’d rather have new friends. I was always looking for others to care for me as my parents never wanted to in my life.

Family is just as toxic as my parents. Going through a bunch of job ads and applying certainly is not helping me one bit to landing a job or accomplishing my major goal: get my own place. Every workshop and speaking to gov agencies have told nothing but lies and not helping anyone land a job. The only skills I have is customer service and IT from learning it as a kid and don’t plan on using it to teach anyone. I just know the old technology not the newer stuff out.’

I also told her I’ve been told to start a business, again, where are you going to get money from? If I had more labor skills, I would turn them into a side job. In therapy, therapist hasn’t drawn anything out from me. I take that back, we have listed strengths of mine: dependable, helpful, caring, loving, understandable, honest/blunt/straightforward/happy go lucky aka child-like personality.

So yea, she said my limited beliefs and I told her where am I suppose to get inspiration from? I have tried to get inspiration from one source one time and it didn’t work for me at all; I was pissed because this person made an income while I was struggling with everything on my own with no help. So, everything I am doing is on my own and left for me to figure out….

Again, still lost at what I should do……

Reply

Shelley May 18, 2014 at 2:36 pm

Limited thinking is a real problem with a lot of people, but you know what, real life situations do matter, so that is absolute garbage. Sorry, I had to say that. I get tired of hearing it myself. If you’re constantly being retraumatized in your current environment, of course that makes a difference and makes it harder. And yes, it is very hard to find jobs in a lot of cases. I feel ya.

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